Treating Genitourinary Syndrome of Menopause

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Women’s Health

As a practicing gynecologist in Coral Springs for many years, and as a menopause specialist (NAMS Menopause Practitioner), one of the most common conditions I diagnose and treat in the 50 to 90 age group is vulvovaginal atrophy, now known in more current terminology as Genitourinary Syndrome of Menopause. This condition encompasses a multitude of symptoms which are disruptive to menopausal women’s quality of life and relationships. The symptoms include vaginal dryness, irritation, itching, burning, and discomfort with intercourse. Urinary symptoms can occur as well, including discomfort during urination, urinary frequency and urgency, and some types of incontinence.


How do we treat women who have one or more of these symptoms? Many women will initially utilize over-the-counter lubricants and moisturizers. In most cases these are only minimally effective. Local vaginal estrogen therapies are available and are effective for some women. Many women fail to adhere to the regimen of inserting creams or tablets, and some are concerned about using a hormonal therapy, although the risks are minimal with local therapies. However many women who have had breast or uterine cancer are cautioned not to use estrogen therapy. There is an oral medication available for these symptoms which is effective for some women, but does have some minimal risks.


Enter a new player to the field of treating symptomatic menopausal women. There is an exciting new treatment available for the restoration of vaginal health. This therapy is known as the MonaLisa Touch laser procedure. This CO2 laser technology was developed in Europe where many women have been successfully treated. The procedure has been embraced by many female pelvic health experts in the United States. It has been performed in the U.S. for two years and is cleared by the FDA. It is backed by several scientific studies that have been published, and there are several studies ongoing. The initial study published in the U.S. was done by well known urogynecologists Dr. Eric Sokol and Dr. Mickey Karram from Stanford University and Christ Hospital in Cincinnati. Results of this study showed significant improvement in all symptoms, including vaginal pain, burning, itching, dryness, discomfort with intercourse, and discomfort with urination, at both three and 12 months post-treatment.


So how is this procedure done, and what should a patient expect? The procedure is performed in the physician’s office. It is considered to be minimally invasive. Only topical anesthetics are used. A CO2 laser is employed to deliver energy to the vaginal wall and on the external skin to remove damaged cells and create a mild thermal effect. The thermal effects promote the synthesis of new collagen and elastic fibers, as well as re-establishing normal blood flow to the area. The procedure takes a few minutes and has very minimal discomfort. The patient receives three treatments at six week intervals. One yearly maintenance treatment is recommended for continued vaginal health.


The MonaLisa Touch laser procedure is safe for women who have had breast or uterine cancer. No estrogen or topical steroids are involved. Besides the symptoms already mentioned, the procedure can be used for women with other vulvar skin conditions such as lichen sclerosus, with proven success. It can be used for women who have had a hysterectomy in the past, a group that typically has pronounced vaginal atrophy if the cervix and ovaries were removed. There are also applications for other types of skin damage in other areas of the body.


In summary, the MonaLisa Touch laser procedure for treatment of Genitourinary Syndrome of Menopause, is a very effective, minimally invasive and safe procedure, which has been scientifically proven to help women with restoration of vaginal health, improvement of sexual function, improvement of urinary symptoms, and overall restoration of quality of life in menopause.


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